Face / Neck Lift

The cheek descends in time producing folds between the cheek/side of the nose and the corner of the mouth. Elevating this area maintains continuity and harmony from the eye lid down. This procedure is a mid face lift. Conventional mid face lifts are powerful in their results.

They involve incisions in the temple and about the lower eye lid that gives access to the mid face. This allows the surgeon to take the cheek and re-suspend this tissue higher. With time, the mid face looses its volume due to the loss of mid face fat. Mid face lifts can therefore resuspend a cheek that has lost volume and in effect is relatively empty. It may well lie higher but the overlying skin and cheek has no volume.

Our approach to the mid face is to increase the volume of fat within the cheek by taking the patient’s fat from their legs and placing the fat through tiny cannulas into the cheek, the lower eye lid and tear trough. Once the cheek has a restored volume we can then mobilise upwards and outwards through the “High SMAS face lift .”

The facial skin lies on a strong tissue within the cheek called SMAS which descends with time. This SMAS attaches to deeper structures of the dial skeleton through thick bands. These band lie within the cheek. Conventional face lift approaches don’t address these ligaments and thus when SMAS pulls its movement is restricted by the deeper ligaments.

The High SMAS lift involves dissecting within the face in front of a gland called the parotid gland. At the front of the gland are found these strong retaining ligaments. These ligaments once divided allow the SMAS to lift dramatically. It is only by releasing these ligaments can we transfer tension on the SMAS to the nasolabial fold and the jowls as well as elevating the entire cheek tissue.

The High SMAS lift allows us to raise the deeper structures to be independent of the overlying skin. This in effect means a deep tissue elevation but we can replace the skin without any wind swept look or other tell tale signs of a face lift. This technique provides the smooth contour to the jaw line.

The lower face to the collar bone, the neck ages through the formation of apparent skin excess with laxity, tight bands from the underlying platysma muscle and the deposition of fat under the jaw line. Simply pulling the neck tissue upwards as per conventional face lifts won’t necessarily increase the jaw profile or tighten the neck skin and platysma.

The skin and underlying platysma needs to pull in a different plane from the facial tightening, this is via the High SMAS face lift being separated from the platysma in the plane of tension. The effect of our approach to the platysma is to define the jaw profile as well as tighten the neck skin but also to increase the angle the side of the neck from the jaw line (please refer the before and after photographs).

Bulky tissue under the jaw can hinder defining the jaw line by tightening the neck tissues. This tissue relates to fat deposition and also the muscles under the jaw line. We reduce this tissue to allow the skin and platysma muscle to tighten against less resistance from the underlying tissue and this therefore gives a cleaner jaw profile.

What we describe above is our algorhytm to rejuvenate the face. This approach has evolved over the last 10 years through reviewing results and undertaking discussion with international colleagues reviewing our and their outcomes, patient feedback and above all technique safety.